Original Article

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Effects of curcumin on Helicobacter pylori infection Vaclav Vetvicka, Jana Vetvickova, Rafael Fernandez-Botran Department of Pathology, University of Louisville, Louisville, KY, USA Contributions: (I) Conception and design: All authors; (II) Administrative support: J Vetvickova; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Vaclav Vetvicka. Department of Pathology, University of Louisville, Louisville, KY 40292, USA. Email: [email protected].

Background: Curcumin is a well-established natural molecule with significant biological and pharmaceutical effects. Its effects on Helicobacter pylori (H. pylori) infection have been repeatedly confirmed both in animal and human models. This study directly compared five different samples to evaluate if the effects are general or if they differ among samples.

Methods: Using a mouse model, we studied the effects of curcumin on lipid peroxide (LPO) level, myeloperoxidase (MPO) and urease activity, number of colonized bacteria, levels of anti-H. pylori antibodies, biofilm formation, IFN-γ, IL-4, gastrin and somatostatin levels in serum, and minimum inhibitory concentration. In addition, we evaluated the effects on biofilm production and antibacterial antibody response.

Results: In all tests, one sample (Sabinsa) was consistently the most active. Conclusions: All curcumin samples showed some anti-H. pylori effects, but only some of the tested samples had significant activity. Keywords: Biofilm; curcumin; Helicobacter pylori (H. pylori) Submitted Nov 23, 2016. Accepted for publication Nov 28, 2016. doi: 10.21037/atm.2016.12.52 View this article at: http://dx.doi.org/10.21037/atm.2016.12.52

Introduction Helicobacter pylori (H. pylori) is a Gram-negative bacterium that selectively colonizes the human gastric epithelium and is epidemiologically linked to stomach and colorectal cancer (1). In addition, it is implicated in the etiology of gastritis and peptic ulcers. Antibody therapy coupled with other treatments is highly effective, but not without complications (2). Over 50% of the world population is infected with these bacteria. The resistance of these bacteria to common antibiotics has been related to the genetic variability and to its ability to develop biofilm (3). In addition, Helicobacter infection has been connected with development of allergies (4). Lately, the focus of numerous investigations has switched to various herbal agents shown to have significant antibacterial activity against H. pylori (5). One of these agents is curcumin (6,7). In addition, curcumin also serves as a biofilm-disrupting agent (8), suggesting multiple roles

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of curcumin in inhibition of H. pylori infection. Curcumin, commonly known as turmeric, is usually a mixture of three curcumoids (curcumin, demethocycurcumin, and bisdemethoxycurcumin) and volatile oil (9). Numerous studies have reported that curcumin has a wide range of biological activities including antimicrobial, antioxidant, antitumor (10), and anti-inflammatory effects. In addition, curcumin has some immunosuppressive activities (11) including expression of cytokines such as IL-1 and TNF-α (12,13). On the other hand, curcumin enhanced phagocytic activity of macrophages (14). In our study, we compared the antibacterial effects of five different types of curcumin. Methods Animals Female, 8-week-old BALB/c mice were purchased from

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Ann Transl Med 2016;4(24):479

Vetvicka et al. Effects of curcumin on H. pylori

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Jackson Laboratory (Bar Harbor, ME, USA). All animal work was done according to the University of Louisville IACUC protocol. Animals were sacrificed by CO2 asphyxiation.

peroxidase (HRP)-conjugated goat anti-mouse IgG (Sigma, St. Louis, MO, USA). Optical density was measured using a STL ELISA reader (Tecan U.S., Research Triangle Park, NC) at 405 nm.

Samples Curcumin C3 complex 95% (sample #1) was purchased from Sabinsa (Sabinsa Corp., East Windsor, NJ, USA), curcumin powder 65% (sample #2) and curcumin 94% (sample #3) from Sigma (St. Louis, MO, USA), curcumin 95 (95%, sample #4) from Jarrow Formulas (Los Angeles, CA, USA), and curcumin 95% (sample #5) from Orcas Naturals (Landing, NJ, USA). Bacteria H. pylori strain ATCC43504 was purchased from ATCC (American Type Culture Collection, Manassas, VA, USA) and cultured on brain-heart infusion (BHI) agar (Sigma) supplemented with 7% sheep blood and incubated at 37 ℃ under microaerobic conditions. Lipid peroxide (LPO) level and myeloperoxidase (MPO) activity Gastric mucosal tissues were scrapped and homogenized in 10 mmol/L Tris buffer (pH 7.4). LPO levels were measured as described by Ohkawa et al. (15). MPO activity was determined by the modified method of Krawisz et al. (16). Urease activity Urease activity in the homogenized gastric tissue was performed as described by O’Riordan et al. (17).

Biofilm formation Bacteria were grown in glass tubes. BHI broths supplemented with 2% β-cyclodextrin (BCD) and 0.016% dimethyl sulfoxide (DMSO) were incorporated as blank and control, respectively. After 7 days of incubation, all culture medium was removed. The test tubes were washed twice with PBS, dried for 30 min at 60 ℃ and 10 mL of 0.1% crystal violet (Sigma) was added for 5 minutes. Unbound stain was discarded and the tubes were again dried for 30 min at 60 ℃. Bound crystal violet was decolorized with ethanol/acetone mixture (80:20, v/v). The level of biofilm formation was quantified by measuring the absorbance of the solution at 570 nm using a spectrophotometer (19). ELISA Serum levels of IFN-γ, IL-4, gastrin, and somatostatin were determined using an ELISA assay as described by Zhang et al. (20). Anti-IFN-γ and IL-4 Quantikine ELISA kits were purchased from B&D Systems (Minneapolis, MN, USA), anti-somatostatin ELISA kit was purchased from LSBio (Seattle, WA, USA), and anti-gastrin ELISA kit from Sigma. All kits were used according to manufacturer’s instruction. Minimum inhibitory concentration test

Enumeration of colonized bacteria

Technique using Mueller-Hinton agar (Oxoid, UK) described by Pattiyathanee et al. (19) was used.

Stomach samples were homogenized in phosphate buffer saline (PBS), cultured on the brucella agar plates incubated under microaerobic conditions. Five days after cultivation, colony counts were performed (18).

Statistics

Anti-H. pylori antibodies

Results

Serum anti-H. pylori IgG were measured using an enzymelinked immunosorbent assay (ELISA). Isolates of H. pylori were used as an antigen at 25 μg protein/well. After incubation and washing, 100 mg of serum was added. Reaction was followed by incubation with horseradish

Evaluation of the changes in IL-4 and IFN-γ levels showed that all samples significantly increased IL-4 serum levels (Figure 1), with the highest effects with samples #1 and #3 and all samples, with the exception of #4, significantly decreased IFN-γ levels (Figure 2). Somatostatin levels

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Student t-test was used to statistically analyze the data.

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Annals of Translational Medicine, Vol 4, No 24 December 2016

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10

30

9 25 Somatostatin (pg/mL)

8 IL-4 (pg/mL)

7 6 5 4 3 2

20 15 10 5

1 0 PBS

#1

#2

#3

#4

0

#5

PBS

#1

#2

#3

#4

#5

Figure 1 Effects of curcumin on serum levels of IL-4. Results

Figure 3 Effects of curcumin on serum levels of somatostatin.

represent mean from three experiments ± SD. *, represents

Results represent mean from three experiments ± SD. *, represents

significant differences between the control and curcumin-treated

significant differences between the control and curcumin-treated

mice at P≤0.05 level.

mice at P≤0.05 level.

30

250 200 Gastrin (pg/mL)

IFN-γ (pg/mL)

25 20 15 10

150 100 50

5 0

0 PBS

#1

#2

#3

#4

#5

PBS

#1

#2

#3

#4

#5

Figure 2 Effects of curcumin on serum levels of IFN-γ. Results

Figure 4 Effects of curcumin on serum levels of gastrin. Results

represent mean from three experiments ± SD. *, represents

represent mean from three experiments ± SD. *, represents

significant differences between the control and curcumin-treated

significant differences between the control and curcumin-treated

mice at P≤0.05 level.

mice at P≤0.05 level.

significantly lowered only sample #1 (Figure 3); and gastrin levels showed significant effects only with samples #1 and #5 (Figure 4). Gastric levels of LPO were significantly decreased by samples #1, #3, and #5 (Figure 5) and all samples, except sample #4, had decreased levels of MPO (Figure 6). The negative control mice levels (without infection) were 0.91 nmol/mg protein with LPO, and 0.49 units/mg protein with MPO activity. The next part of the study was focused on bacterial enumeration and presence of urease. Urease was detected in all tested samples, but samples #1 and #3 significantly lowered the H. pylori counts (Table 1). We then studied

the effects of tested samples on H. pylori formation. As summarized in Table 2, in higher concentration, we found strong effects of samples #1, #2, and #5 and in lower concentration, only sample #1 showed small effects. The final part of this study measured direct effects of curcumin supplementation of levels of anti-H. pylori IgG. Results given in Figure 7 show that all samples increased production of specific antibodies, with samples #1, #3 and #5 showing the strongest effects.

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Conclusions H. pylori is a highly mobile Gram-negative bacterium,

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Vetvicka et al. Effects of curcumin on H. pylori

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LPO levels (nmol/mg protein)

1.4

Table 1 Bacterial enumeration and presence of urease

1.2 1

Group

CFU/g

Negative control

0

Urease −

0.8

Positive control

58.9±7.2

+

0.6

#1

22.1±3.3*

+

#2

50.5±5.5

+

#3

41.7±4.9*

+

#4

50.6±6.7

+

#5

45.1±7.2

+

0.4 0.2 0

PBS

#1

#2

#3

#4

#5

Figure 5 Effects of curcumin on LPO abundance in gastric mucosal tissue. Results represent mean from three experiments ± SD. *, represents significant differences between the control and

*, significant differences between sample and PBS at

Effects of curcumin on Helicobacter pylori infection.

Curcumin is a well-established natural molecule with significant biological and pharmaceutical effects. Its effects on Helicobacter pylori (H. pylori)...
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